Bridging the Gap: Evaluating pen-to-needle time for reserve antibiotics in sepsis management at a tertiary hospital in Sri Lanka Comparison with 2021 Surviving Sepsis Campaign recommendations

The 2021 Surviving Sepsis Campaign guidelines emphasise the importance of early antibiotic administration in sepsis. This study aimed to evaluate the pen-to-needle time for reserve antibiotics in patients with sepsis at the National Hospital of Sri Lanka (NHSL). A four-month prospective observational audit was conducted from March 2022, analysing the prescription and administration times of reserve antibiotics in patients with sepsis in inpatient wards and intensive care units (ICUs). Of the 50 cases involving reserve antibiotics, 66% were prescribed for septic patients. Alarmingly, only 6% of these antibiotics were administered within one hour, and 22% were delayed beyond 24 hours. ICU administration times were generally faster (4-12 hours in 65.3% of cases) compared to wards (≥24 hours in 33.3%).This audit reveals substantial delays in reserve antibiotic administration in patients with sepsis. Expedited access strategies, such as streamlined authorisation protocols, are needed to improve adherence to SSC guidelines and optimise patient outcomes.